IN the opening years of the 20th century, a woman who found herself in a certain condition and did not want to let nature take its course had to choose between a number of unpalatable options.

If traditional remedies such as a bottle of gin and a hot bath or throwing herself down the stairs didn’t work, she could send away for one of the various brands of “Reliable Female Pills” cryptically advertised on the back pages of newspapers.

If the pills proved in fact to be unreliable, which they almost certainly would, more active measures might be sought.

As writer and filmmaker Shirley Barrett documents in a new anthology of writing about abortion, a range of practitioners advertised termination services to women at the time. One advertisement from 1900 read:

LADIES – Your Troubles at an End by Applying to MADAME ORME, MD, SYDNEY’S ONLY LADY SPECIALIST, for a list of her REMEDIES and genuine testimonials, FAILURE IMPOSSIBLE …

When Madame Orme (real name: Rosaline Brown) appeared at the inquest of one of her patients, a widow with five children, she was asked by the coroner about the meaning of the letters “MD” after her name.

“There is no special significance in the letters MD,” she replied. “They are used for attraction more than anything else.”

Madame Orme was just 20 years old at the time and had started her business aged 17.

One of her competitors in what was clearly a thriving industry was Dr Frederick Marshall, a respected medical man with rooms on Sydney’s Macquarie Street.

Marshall had, he claimed, studied in Edinburgh, Vienna, Berlin, Leipzig, Dresden, Budapest and London, and had spent 3 years as district surgeon at the Sydney Hospital, where he had treated more than 16 000 patients.

He was also, as Barrett has uncovered, implicated in the deaths of at least eight women between 1901 and 1905, women who died from perforation of the uterus, septicaemia or uncontrolled haemorrhage after botched abortions.

Marshall repeatedly found himself in court answering accusations ranging from performing an illegal procedure to murder. In all but one case, he was exonerated.

In the absence of reliable contraception, and with single motherhood putting any respectable woman beyond the pale, abortion was a thriving and highly profitable trade. Its illegal status left it unregulated, with no protection for the desperate women who turned to scoundrels such as Marshall for help.

A century on, things have improved, at least in countries like Australia, though there is no room for complacency.

The world has made significant progress on four of the five main causes of pregnancy-related mortality (severe bleeding, severe infection, blood pressure disorders and obstructed labour), says MSF.

“But unsafe abortion – the only almost completely preventable cause – has been largely forgotten.”

Abortion has long been a political football, with many of its most vocal opponents belonging to the half of the human species who will never be confronted by the dilemma of how to deal with an unwanted pregnancy.

The removed phrase did not even mention abortion, but said: “recognizing the importance of providing timely assistance to survivors of sexual violence, urges United Nations entities and donors to provide non-discriminatory and comprehensive health services, in line with Resolution 2106”.

Even in Australia, it is not always easy for women to access safe abortion services.

Laws vary widely around the country, as noted recently in the MJA. The procedure was recently decriminalised in Queensland but remains a crime in New South Wales. Other jurisdictions have various restrictions in place.

Those who seek to restrict women’s access to abortion might do well to consider that their efforts are unlikely to save embryos but may well end up harming the women and girls who find themselves pregnant against their will.

“When a woman or girl is determined to end her pregnancy she will do so, regardless of the safety or legality of the procedure,” says MSF. “Where safe abortion is not available, she will risk her life with an unsafe abortion, often because the prospect of continuing the pregnancy is unbearable.”

Enter Dr Marshall and his ilk.

Jane McCredie is a Sydney-based health and science writer.

The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.

12 thoughts on “Restricting abortion harms women”

Don’t know enough about Dr Marshall to say, but given that this is an article about the problems of restricting abortion, and that it was an operation that he was providing that few others were, 8 deaths from 16000 procedures at the turn of last century (pre-antibiotics) for an operation that was then assuredly illegal may not be a sufficient basis on which to traduce him as a “scoundrel”….

It is depressing that articles like this still have to be written in 2019.

I am old enough to have cared for the complications of backyard abortions in my early career and would not wish that on anybody.

It seems that some are prepared to risk women’s lives and health to serve their own moral, religious or psychological needs.

What is particularly depressing is that some of these folk are medical. It is also an interesting curiosity that those who petition and write articles on the perils of abortion as ‘concerned doctors’ are often frequent fliers, their names appearing on similar submissions around unrelated issues ( LGBTI marriage, Safe Schools, Assisted dying etc etc ) which rather suggests that non medical factors may be driving this “medical’ opinion. They often also come from medical disciplines which will have given them limited, if any, exposure to the issues at hand.

A perusal of related websites run by Church organisations reveals medical information which is distorted, wrong or manipulated in order to influence women’s choices – “post abortion syndrome ” being only one example.

Surely the least that we are entitled to expect from any doctor or healthcare organisation is that they provide safe, reliable information for women and the wider community and endeavour to meet women’s needs in their own terms and not those of the doctor or hospital. This goes to the fundamentals of medicine.

I have long considered abortion in the ‘harm minimisation’ category.
We don’t have capital punishment for any ‘offence’ in this country & so it shouldn’t be the consequence of an unplanned pregnancy (as it maybe with illegal abortions)

“Abortion is clearly wrong, but it’s not that simple” (Jordan Peterson)

“Surely the least that we are entitled to expect from any doctor or healthcare organisation is that they provide safe, reliable information for women and the wider community…”. Indeed, Andrew Watkins(#2), but such full disclosure might also result in them discovering that a foetal heartbeat can be detected at 6 weeks in utero.

Zealots on either side of the debate trying to steamroller an argument – particularly an argument from (medical) authority – through a debate that needs a nuanced view of morality, biology, psychology and rights, are really unhelpful.

Andrew Watkins note mentions that some of the most vocal opponents of abortion are serving their own religious or ‘moral’ aims. I am also concerned that some of these individuals are also opposed to the provision of safe, effective and easily accessible contraceptive measures. Accurate knowledge about and access to contraception can be sadly missing particularly among young women and those coming from disadvantaged backgrounds.

Have to agree that there isn’t enough info presented to discredit Dr Marshall, who may have been acting on financial incentive alone, but could just have likely been trying to provide a service to desperate patients, at significant legal risk too. 8 deaths in 6 years sounds more than reasonable over 100 years ago…

What a tragedy is abortion. What an astounding biological construction is the development of an entire creature from a beginning with just 2 cells, an extraordinary complex outcome from aeons of evolution. Our understanding of the physiological processes involved is feeble compared to their mindless elegance. Hence to destroy with abortion is like an insult to nature, and this seems unarguably self-evident. Abortion should be done safely and with regret.

I agree with the necessity of availability of abortion but think it appropriate to point out that abortion is the most costly and most dangerous form of contraception. Freely available contraception is the best and first line of defence against unwanted pregnancy.
There is the further issue that, with the entry of women into the work force together with the necessity of appropriate training and qualifications, the age at which women start their families is increasing at the same time as they start maturing at a younger age.

My heart breaks for every woman who is put in a position that they must consider an abortion but this is should never be the solution (with the exception of mother’s life is in danger). 45% of abortions may be unsafe for the mother, but 100% of abortions are unsafe for the unborn child.

We need to do better at providing support for mother’s who are unexpectedly pregnant, including improved adoption services so that people no longer see abortion as a necessity. It is possible to care for both a mother and an unborn child – to accept that abortion should not be an option but more care is needed. Part of that solution needs to be societal (if not legislative) to demand the men share the responsibility for dealing with unwanted pregnancy because they are ALWAYS as responsible (if not more so) for the situation.

Thanks for comment 11 / its not an uncommon story- – people often seem to remember/grieve over the procedure for many years- wouldn’t it be reasonable to acknowledge ongoing effects to promote contraception/‘avoiding’ pregnancy- I think some men would not have any understanding/knowledge of this and think abortion has no consequence.